In September 2025 World Health Organization (WHO) published results of an extensive analysis, Cancer research and development landscape: overview of 1999-2022 period. The report presents interesting insights and findings for cancer treatment, based on 112 899 conducted cancer clinical trials in the WHO’s International Clinical Trials Registry Platform (ICRTP).
The clinical trials are generally defined as any research study that prospectively assigns human participants or groups of humans to one or more health-related interventions to evaluate the effects on health outcomes (WHO, Clinical trials). Cancer clinical trials are important due to their contribution to our understanding of cancer, its treatment and improvements of collective health care practices.
Main messages of the report are:
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- Conducted cancer clinical trials are disproportional between high-, middle- and low-income countries, since majority were conducted in the high-income countries (76% in 2022).
- The number of cancer clinical trials is less than 10% of all trials in most countries. Exceptions are the USA (32%), China (19%) and Japan (13%), while the lowest numbers were observed in Africa. 63 countries are without any trials listed in the ICRTP.
- Breast cancer, lung cancer, lymphomas, colorectal cancer, leukaemia and prostate cancer are the most frequently studied tumours on the global level. Despite that, the cancer clinical trials are not aligned with the cancer prevalence and mortality patterns (cancer burden).
- A significant majority of clinical trials (85%) are conducted without cooperation between high-, middle- and low-income countries (i.e. single-country studies).
- Paediatric patients (children under 14 years) are rarely included in cancer clinical trials (less than 4%), although this group of patients has its own unique needs.
- Medicine-related trials present 61% of all registered trials, while other, also important trials – like procedures, biological interventions, behavioural interventions, devices, radiation and diagnostic tests – are underrepresented, although they considerably contribute to understanding of cancer diagnosis, treatment and management.
- On average, it takes 4-6 years from trial registration to publication, which is accompanied with lengthy drug development process. Furthermore, around 30% of trials are unpublished after seven years after enrolment of the final study participants.
These findings come with recommendations to overcome these disparities, in order to accelerate progress in the cancer field: collaborative efforts, fostering equitable partnerships, effective resource allocation, development of context-specific research strategies, strategic shift in research priorities, improving standardised reporting practices, etc.